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Dear Socrates

Dear Socrates

Having returned from the turn of the Fourth Century B.C. to the turn of the Twenty-First A.D., Socrates has eagerly signed on as a Philosophy Now columnist so that he may continue to carry out his divinely-inspired dialogic mission.

Dear Socrates,

This is highly unusual, but I see no reason not to go ahead with it and a good reason for doing so. I am writing to you, even though I am your fellow columnist in Philosophy Now. I have been grappling with an issue, which I was going to write about myself; but then it occurred to me that this issue is "yours" if ever there was one.

It relates to one of my earlier columns (in Issue 54) about a chronic health problem I have. I experience pain, which is usually moderate but occasionally excruciating. I take medication, but it is not clear whether it is affecting the pain, which could be getting better or worse on its own. I have been to five specialists at last count, and all have thrown up their hands about the cause of the pain. OK, I can't expect doctors to be miracle workers; there is no reason why they should know everything. But I still have reason to fault these doctors, I think, and, oddly, this time the etiology seems clear: You, Socrates, are the cause of their poor treatment of me!

Was it not Socrates who made his name by exposing the pretensions to knowledge of the experts of his day? You found that they did indeed have "technical proficiency" in some specialized areas, but (and I quote from Plato), "on the strength of their technical proficiency they claimed a perfect understanding of every other subject, however important, and I felt that this error more than outweighed their positive wisdom" (Apology 22d, tr. Hugh Tredennick). Well, today it seems that medical doctors have taken your admonishments very much to heart, for every one that I saw was only too happy to proclaim his ignorance of anything beyond his narrow specialization. Each doctor put me through a battery of tests, which he knew about thoroughly. Then, finding nothing significant from these, he kicked me out the door! He had absolutely nothing else to tell me, or to do for me.

Most amazing to me is that this was true even of my general practitioner ... except that his ignorance was total. That is, given that he was not a specialist, he claimed no knowledge of anything! All he could do was refer me to specialists. See what thou hast wrought, Socrates. I need somebody to take care of me, but, because of you, everyone is now too “wise” to believe they can help me. As I pointed out in my column, I have been left to be my own doctor.

Painfully yours,
Joel Marks, Ph.D. (not M.D.)

Dear Joel,

Your letter highlights the irony of having someone who, in your words “made his name by exposing the pretensions to knowledge of the experts” make his comeback as an advice columnist. But perhaps I can avoid the most egregious inconsistency by restricting my advice to my area of technical proficiency – the ethically good life.

You accuse me of teaching all experts, including physicians, to limit their knowledge claims to their areas of genuine expertise. To that charge I plead guilty – with pride. Would you have them tell you false things to comfort you, or put you through costly, painful treatment regimens which they had no reason to believe might be effective? No, I am glad, if it is true, that doctors now say only what they truly believe, and believe only that for which there is good evidence.

But your real complaint is not that doctors are epistemologically modest (a virtue that I taught them), but rather that they are ethically deficient, a vice that I condemn. And your implication that the latter follows from the former is fallacious. Your doctors’ not knowing what is wrong with you, nor what to do next, is no reason for them to abandon you. They could say, “I’ve tested you for everything I can think of. I’ve consulted with every specialist that might shed light on what is wrong. I’ve attempted every treatment that I thought had any chance of working. But I have not alleviated your suffering. My technical expertise is, for now, exhausted. But my role as physician is not exhausted by my technical expertise. I am committed to treating your medical problem as if it were my own. As long as you cannot escape it, I will not abandon it. I will keep trying to discover its cause, I will keep trying to eradicate its effects. I will keep trying to help you adjust to it as long as it remains uncured. My lack of knowledge does not affect my ethical commitment.”

It is this attitude that ideally distinguishes a “calling,” a “profession,” from a mere job. The physicians you have dealt with are not “too ‘wise’ to believe they can help you”: they are too indifferent to commit themselves to your well-being, a commitment that requires no special knowledge. You have gone to MDs who act like mechanics: you need to find some who act like doctors.

Yours as ever,


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